In 2019, I experienced a miracle of sorts. After more than a decade of coping with irregular menstrual cycles and infertility caused by Polycystic Ovary Syndrome (PCOS), I learned that I was pregnant. At the age of 33, I found myself navigating a major life milestone that I didn’t think I would ever get to experience. When I saw the faint lines indicating a positive on my home pregnancy test, I was hesitant to believe it could be true. A visit to Open Door’s wellness center confirmed the pregnancy, so I went ahead and scheduled my first trimester appointments for prenatal care at the Sutter Clinic — the only obstetrics practice in Del Norte County.

I was nervous about receiving prenatal care through Sutter. I had heard numerous horror stories from friends and relatives who had experienced labor and delivery at Crescent City’s Sutter Coast Hospital. Locals living in a rural county know that finding quality medical care is a huge challenge. Sutter was the only game in town, so we decided to give them a chance. 

Our initial visit was traumatic, to say the least. The obstetrician on staff at the time didn’t seem to comprehend the long cycles that can accompany PCOS and argued with me about how far along I was. He insisted that I was already 11 weeks pregnant, and that as such, we should be able to see the baby’s heartbeat on a pelvic ultrasound. I had been meticulously tracking my cycles for almost two years. I knew when ovulation and conception took place, and I knew that I was actually only 8 weeks along — it’s generally too early to find a heartbeat on an ultrasound. The OB dismissed my data and noted “MMC” (missed miscarriage) in my chart when no heartbeat was detected.

I was devastated. This was a very wanted pregnancy and I was being told that we might just have to wait for things to flush themselves out. “Come back in three weeks,” he told me. “We’ll check again then.”  

Those three weeks were psychological torture. I can’t begin to articulate the terror of imagining your (very wanted) baby dead inside of you and then being told that all you can do is wait.

When we returned to the clinic, my intuition proved correct. We saw my son’s fetal form on the ultrasound clear as day, with his little nubby developing arm waving on the screen as if to say “Hey mom! I’m still here!” His father and I resolved that day that we would not be scheduling any further prenatal care appointments with Sutter Coast. 

Consulting with sisters and friends who had experienced their pregnancies locally, we decided to seek prenatal care in Arcata at Open Door’s North Country Clinic, housed within the Mad River Hospital campus. I heard good things about Mad River’s Trillium Birthing Center. For example, their clinic actually had certified nursing midwives on staff and even tubs for those who wished to manage their labor pains in water! It was admittedly a significant inconvenience to have to make the 90+ minute drive down highway 101 through the crumbling Last Chance Grade stretch every few weeks for appointments. But I certainly couldn’t trust the obstetrician at Sutter Coast after receiving such an egregious misdiagnosis. 

Thankfully, my pregnancy continued with only mild complications. Although I was nervous about going into labor and traveling 70+ miles to get to the hospital, I was able to give birth to a beautiful baby boy at Trillium. The birthing center itself was understaffed, as it was a holiday weekend, but we were able to befriend a wonderful nurse with a fantastic sense of humor who helped keep us in good spirits. 

Imagine my shock, five years later, to learn that the Mad River Hospital’s Trillium Birthing Center was closing its doors.

According to a press release from Mad River Community Hospital, in the past four years, the facility went from performing around 60 deliveries per month, to less than 25. Apparently, in a for-profit healthcare system, those figures aren’t robust enough to justify the cost of providing crucial labor and delivery medical care. 

Personally, I find the notion that profit margins could play any role in dictating quality of care to expectant mothers and their babies to be infuriating. What does that say about our priorities?  On a national scale women have been reeling from the Dobbs v. Jackson Supreme Court decision that revoked our legal protections for reproductive autonomy. The general assumption is that in an infamously “blue” state like California — and especially in a notoriously left-leaning county such as Humboldt — comprehensive reproductive care honoring a person’s choices surrounding pregnancy and birth would be a given. And yet, folks who choose to carry a pregnancy to term are now finding their options severely limited. St. Joseph’s Hospital in Eureka is currently facing a lawsuit from the California attorney general for denying emergency abortion care to a woman whose pregnancy was no longer viable. Humboldt will soon be facing the dilemma we’ve dealt with here in Del Norte for quite some time: extremely limited options for maternity care. 

An interview with Del Norte physician assistant Lynn Szabo on KFUG’s Health Matters revealed that United Indian Health Services had been referring approximately 25 expectant mothers to Mad River per year. In contrast to the policies in place at St Joseph and Sutter Coast hospitals, the birth plan options provided at the Trillium birthing center had been slightly more accommodating of indigenous cultural traditions. On top of the UIHS figure, I can only speculate as to how many Del Norte women were self-electing, as I did, to transfer their birthing care to Trillium. The ripple effects of the administrative decision to close Trillium are not isolated to Humboldt residents alone.

Admittedly, a LOT has changed in the medical world in the past five years. I certainly can’t say that I thought I’d become a first-time parent just as an unprecedented global pandemic struck, nor did I suspect that I’d find myself scrambling to accommodate my son’s early childhood social-emotional development during a quarantine lockdown. It stands to reason that these extraordinary circumstances paired with the inevitable march of time would bring broad changes to our birth rates and healthcare system. I can say that in casual conversation with Del Norte women, a shared sentiment exists that the quality of reproductive care provided at Sutter Coast Hospital has improved markedly since obstetrician Dr. John Kirk moved to town. I can also say that having only one resident OB-GYN in such an isolated region does a disservice to those residing here who choose to carry their pregnancies to term. So what can we do about this? Fighting for the right to comprehensive reproductive healthcare while living in a rural region certainly feels like an uphill battle, especially within the context of a national model that allows the moral hazard of a profit motive to factor into medical decisions. I wish I had the answers. What I do know is that we must keep sharing our stories and speaking out about the barriers to care that we face here in Del Norte County. I would like to encourage any local women and/or gender-non-conforming birthing persons with stories like mine to speak their truth. If you are impacted by these changes and have any constructive ideas for systemic improvements, reach out to hospital administrators and elected representatives. If we dare to hope to create a better model for future generations, we cannot continue to suffer in silence.